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Eun S. Huh, Bennie H. Jeng; Ophthalmologic Consultations after Non-ophthalmologic Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):299.
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Corneal abrasion is the most common post-surgical and post-anesthesia ophthalmic complication after non-ophthalmologic surgery, and ophthalmologic consultation is often urgently requested while the patient is still in the Post-Anesthesia Care Unit (PACU) or in the Intensive Care Unit (ICU). The aim of this study was to determine the rate of ophthalmologic consultations after non-ophthalmologic surgery at our institution, and to determine the rate of corneal epithelial injuries in this setting.
We retrospectively reviewed the medical records of all post-surgical patients for whom ophthalmologic consultation was requested while the patients were in the PACU or ICU at the main campus of the Cleveland Clinic from January 1, 2007 to December 31, 2007. Data recorded included the type of surgery, intra-operative surgical positioning, details of anesthesia preparation, the reason for the ophthalmology consultation, and the findings of the ophthalmologic consultation. Statistical calculations regarding the number of and types of surgeries performed during this time period were performed using data obtained from a database.
Out of the 35,567 non-ophthalmologic surgical cases performed during the study period, there were 61 consultations requested of the ophthalmology service. Thirty-one of these 61 patients, or 0.09% of total surgical patients, were found to have evidence of corneal epithelial abnormalities. All of these 31 patients had pain and/or foreign body sensation as their chief complaint. Of the 31 patients who developed corneal epithelial injuries, 26 patients had their eyes taped shut during the surgical procedure; for the remaining 5 patients, the anesthesia operative notes did not indicate whether or not the patients’ eyes were taped. Corneal epithelial injuries occurred with the highest rate in patients who underwent surgeries on Mondays compared to any other day of the week.
Post-surgical ophthalmologic sequelae after non-ophthalmic surgery are uncommon events. However, corneal epithelial abnormalities resulting in patient discomfort can still occur despite careful attempts to protect patients’ eyes with eyelid taping.
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